Adolescents With Bipolar Depression May Have Increased Metabolic Syndrome Risk

Adolescents with bipolar disorder (BD) depression may be at increased risk for metabolic syndrome (MetS), according to study results published in Journal of Child and Adolescent Psychopharmacology.

Researchers conducted a case-control study among a subset of 607 adolescents (cases, n=332; controls, n=275) using a propensity matching approach. Data was sourced from the National Inpatient Sample (NIS), which collected data from 4411 hospitals in 44 states in the United States. Adolescent inpatients (N=248,348) aged 12 to 18 years who were discharged from the hospital with a mood disorder diagnosis were evaluated for MetS risk. Metabolic syndrome was defined as 3 of the following: diabetes, obesity, hypercholesterolemia, or hypertension.

Participants’ mean age was 16.3 (SD, 1.7) years, 58.2% were girls, and 40.1% were White. A total of 83.5% of participants had a primary diagnosis of major depressive disorder (MDD), 16.5% had a primary diagnosis of BD depression, 50.4% had an anxiety disorder comorbidity, 15.7% had an attention-deficit/hyperactivity disorder (ADHD) comorbidity, 14.8% had a substance use disorder, and 4.1% had a disruptive behavior disorder comorbidity.

Stratified by cases and controls, the case participants had a higher incidence of obesity (84.9% vs 3.6%; P <.001), hypertension (81.0% vs 1.8%; P <.001), diabetes (72.8% vs 9.1%; P <.001), and hypercholesterolemia (67.2% vs 3.6%; P <.001) compared with control participants, respectively.

Among the case participants, 262 had MDD and 70 had BD depression. The patients with BD depression were older (mean, 16.9 vs 16.1 years; P =.001), more likely to be Black (69.7% vs 19.6%; P <.001), more had obesity (92.8% vs 82.8%; P =.040), and more had ADHD (35.7% vs 11.5%; P <.001). Fewer participants with BD depression had hypercholesterolemia (56.5% vs 70.2%; P =.031) than the patients with MDD, respectively.

Risk for MetS was associated with BD depression compared with MDD (adjusted odds ratio [aOR], 2.42; 95% CI, 1.47-3.97; P =.001), disruptive behavior disorders (aOR, 4.45; 95% CI, 1.55-12.78; P =.006), and substance use disorder (aOR, 0.31; 95% CI, 0.19-0.50; P <.001) compared with those with no psychiatric comorbidities.

The results of this study may have been biased, as MetS was determined using diagnostic coding of metabolic comorbidities.

Study authors conclude, “Among the adolescents with mood disorders, a primary diagnosis of BD depression and comorbid disruptive behavior disorders increases the odds of MetS, while comorbid substance use disorder lower the odds of MetS. Among the various parameters of MetS, the rates of obesity were significantly higher among adolescents with BD depression, whereas hypercholesterolemia was higher among those with MDD.”

Disclosure: An author declared affiliations with industry. Please refer to the original article for a full list of disclosures.